Real-Ear Measures

Real-Ear Measures

Real-ear measures (REM) are recommended in hearing aid fitting. However, reports suggest that only approximately 30 percent of audiologists routinely perform REM. Rationale (or excuses) for not performing REM are numerous, but little peer-reviewed research has been conducted to support or refute the use of REM in regards to benefit in speech understanding and subjective quality of fitting.

Recently, Valente et al. (2017) examined the difference in words, and phoneme recognition in quiet and noise (using the HINT) and subjective outcomes (APHAB and SSQ) between manufacturer first fit and NAL-NL2 programmed using REM. Twenty-four participants with high-frequency hearing loss and no prior hearing aid experience were recruited. The study involved a cross-over design where all participants were fit with both methods. The order of the fittings was counterbalanced and random. Both fittings included the use of REM methods (placement of a probe and measuring device output), but only in the NAL-NL2 were programming changes made to match targets.

The results showed a median 15 percent advantage in word recognition and 7.7 percent advantage for phonemes for soft speech in quiet for the NAL-NL2 REM fit devices. However, no significant differences were seen for tests in noise. Further, nearly 80 percent of participants preferred the REM fitting versus first-fit. More details can be found the manuscript.